Antitrombinska aktivnost kao značajan prediktor ranog mortaliteta kod bolesnika sa embolijom pluća
Sažetak
Uvod/Cilj. Uloga aktivnosti antitrombina (AT) u predviđanju rane smrtnosti kod bolesnika sa plućnom embolijom (PE), merena u ranoj fazi bolesti, još uvek nije istražena. Cilj rada bio je da se ispita prediktivna vrednost aktivnosti AT za 30-dnevni mortalitet, merena na prijemu, kod bolesnika sa PE. Metode. Retrospektivnom studijom preseka, praćeni su svi bolesnici sa akutnom PE, lečeni u našoj Klinici u periodu od 2014. do 2021. godine. Bolesnicima je na prijemu uzimana venska krv za laboratorijske analize uključujući i merenje aktivnosti AT. Osnovni podaci o bolesnicima beleženi su na prijemu, a primenom univarijantne analize testirana je njihova povezanost sa 30-dnevnim mortalitetom. Prediktivni značaj vrednosti AT za 30-dnevni mortalitet testiran je kroz kvartilne vrednosti tako što je prvi kvartil poređen sa svim ostalima zajedno. Cox-regresiona analiza korišćena je u multivarijantnoj analizi, gde je osnovnom modelu (AT, godine i pripadnost riziku u dve grupe) dodavan po jedan parametar, označen kao značajan u univarijantnoj analizi. Rezultati. U studiju je bilo uključeno ukupno 378 bolesnika sa PE. Ukupan 30-dnevni mortalitet iznosio je 7.9% (30 bolesnika). Bolesnici sa aktivnošću AT u prvom kvartilu imali su značajno veći rani mortalitet u poređenju sa onima koji su tu aktivnost imali u ostalim kvartilima zajedno (log rank p = 0,001). Varijabla AT je zadržala značajnu prediktivnu vrednost za rani mortalitet i u multivarijantnoj analizi bez obzira na prisutni komorbiditet, koji je takođe značajno uticao na mortalitet. Zaključak. Niska aktivnost AT izmerena na prijemu kod bolesnika sa PE je značajan i nezavisan prediktor 30-dnevnog mortaliteta.
Reference
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